Uganda (population 25 million) is a landlocked country in Eastern Africa that covers an area of 236, 040 km2. There are eight palliative care organizations that deliver some 155 services. These ...
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Uganda (population 25 million) is a landlocked country in Eastern Africa that covers an area of 236, 040 km2. There are eight palliative care organizations that deliver some 155 services. These include Hospice Africa Uganda (HAU), Kitovu Mobile Home Care, The Mildmay Centre, Joy Hospice, The Palliative Care Unit; Lira Regional Referral Hospital, and Association François-Xavier Bagnoud (AFXB). The reimbursement and funding for services are shown. The chapter also addresses opioid availability and consumption. The Palliative Care Association of Uganda (PCAU) is a national association that aims to introduce and maintain standards, bring together key players and stake-holders, establish a journal, quarterly continuing medical education (CME) update, publications, advocacy, and co-ordination of education and CME throughout the fifty-six districts of Uganda. Education and training of health professionals and non-health professionals is discussed. Furthermore, the history and development of hospice-palliative care in Uganda is reported. The principles of health care ethics include beneficence, non-maleficence, respect for autonomy, and justice.Less

Uganda

Michael WrightDavid ClarkJennifer Hunt

Published in print: 2006-08-24

Uganda (population 25 million) is a landlocked country in Eastern Africa that covers an area of 236, 040 km2. There are eight palliative care organizations that deliver some 155 services. These include Hospice Africa Uganda (HAU), Kitovu Mobile Home Care, The Mildmay Centre, Joy Hospice, The Palliative Care Unit; Lira Regional Referral Hospital, and Association François-Xavier Bagnoud (AFXB). The reimbursement and funding for services are shown. The chapter also addresses opioid availability and consumption. The Palliative Care Association of Uganda (PCAU) is a national association that aims to introduce and maintain standards, bring together key players and stake-holders, establish a journal, quarterly continuing medical education (CME) update, publications, advocacy, and co-ordination of education and CME throughout the fifty-six districts of Uganda. Education and training of health professionals and non-health professionals is discussed. Furthermore, the history and development of hospice-palliative care in Uganda is reported. The principles of health care ethics include beneficence, non-maleficence, respect for autonomy, and justice.

This chapter discusses palliative care programmes in the south Indian state of Kerala, specifically the Neighbourhood Network in Palliative Care (NNPC). This programme recruits volunteers from the ...
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This chapter discusses palliative care programmes in the south Indian state of Kerala, specifically the Neighbourhood Network in Palliative Care (NNPC). This programme recruits volunteers from the local community and trains them to identify the problems of the chronically ill in their area and to intervene effectively. These volunteers have active support from a network of trained professionals.Less

Neighbourhood network in palliative care, Kerala, India

Dr Suresh Kumar

Published in print: 2009-09-17

This chapter discusses palliative care programmes in the south Indian state of Kerala, specifically the Neighbourhood Network in Palliative Care (NNPC). This programme recruits volunteers from the local community and trains them to identify the problems of the chronically ill in their area and to intervene effectively. These volunteers have active support from a network of trained professionals.

Nigeria (population 137.25 million) is a country in Western Africa that covers an area of 923, 768 km2. Palliative care services are provided by two organizations in Nigeria, the Palliative Care ...
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Nigeria (population 137.25 million) is a country in Western Africa that covers an area of 923, 768 km2. Palliative care services are provided by two organizations in Nigeria, the Palliative Care Initiative (Ibadan) and Hospice Nigeria (Lagos). Palliative care services in Nigeria are undeveloped. There is continuing resistance to some palliative care concepts including opiate use, the multidisciplinary team approach to the management of medical problems, and the inclusion of patient and family as the unit of care. Reimbursement and funding for services are shown. There is no national association in the country. The history and development of hospice-palliative care in Nigeria is covered. The chapter specifically describes life/oral histories, the public health context, health care system, and political economy.Less

Nigeria

Michael WrightDavid ClarkJennifer Hunt

Published in print: 2006-08-24

Nigeria (population 137.25 million) is a country in Western Africa that covers an area of 923, 768 km2. Palliative care services are provided by two organizations in Nigeria, the Palliative Care Initiative (Ibadan) and Hospice Nigeria (Lagos). Palliative care services in Nigeria are undeveloped. There is continuing resistance to some palliative care concepts including opiate use, the multidisciplinary team approach to the management of medical problems, and the inclusion of patient and family as the unit of care. Reimbursement and funding for services are shown. There is no national association in the country. The history and development of hospice-palliative care in Nigeria is covered. The chapter specifically describes life/oral histories, the public health context, health care system, and political economy.

This chapter presents an account of a regional initiative undertaken in north eastern Switzerland to develop community-based palliative care. The Kerala (India) Neighbourhood Network in Palliative ...
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This chapter presents an account of a regional initiative undertaken in north eastern Switzerland to develop community-based palliative care. The Kerala (India) Neighbourhood Network in Palliative Care (KNNPC) was identified as an excellent example of a model of community palliative care that effectively addresses some of the difficulties experienced by people who wish to die at home, and their primary carers. A participatory community development project was initiated and divided into three steps: 1. Initial evaluation of status; 2. Initiation of community round tables (a meeting of peers for discussion and exchange of views); and 3. Formulation of recommendations and concrete action plans. This project outlines a participatory action research project that brought together professionals, volunteers and community leaders to develop a community palliative care programme across three areas in north eastern Switzerland.Less

Community palliative care in Switzerland: from assessment to action

Steffen EychmüllerFranzisca Domeisen Benedetti

Published in print: 2012-12-06

This chapter presents an account of a regional initiative undertaken in north eastern Switzerland to develop community-based palliative care. The Kerala (India) Neighbourhood Network in Palliative Care (KNNPC) was identified as an excellent example of a model of community palliative care that effectively addresses some of the difficulties experienced by people who wish to die at home, and their primary carers. A participatory community development project was initiated and divided into three steps: 1. Initial evaluation of status; 2. Initiation of community round tables (a meeting of peers for discussion and exchange of views); and 3. Formulation of recommendations and concrete action plans. This project outlines a participatory action research project that brought together professionals, volunteers and community leaders to develop a community palliative care programme across three areas in north eastern Switzerland.

This book introduces a process-based, patient-centered approach to palliative care that substantiates an indication-oriented treatment and radical reconsideration of our transition to death. Drawing ...
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This book introduces a process-based, patient-centered approach to palliative care that substantiates an indication-oriented treatment and radical reconsideration of our transition to death. Drawing on decades of work with terminally ill cancer patients and a trove of research on near-death experiences, Monika Renz encourages practitioners to not only safeguard patients’ dignity as they die but also take stock of their verbal, nonverbal, and metaphorical cues as they progress, helping to personalize treatment and realize a more peaceful death. Renz divides dying into three parts: pre-transition, transition, and post-transition. As we die, all egoism and ego-centered perception fall away, bringing us to another state of consciousness, a different register of sensitivity, and an alternative dimension of spiritual connectedness. As patients pass through these stages, they offer nonverbal signals that indicate their gradual withdrawal from everyday consciousness. This transformation explains why emotional and spiritual issues become enhanced during the dying process. Relatives and practitioners are often deeply impressed and feel a sense of awe. Fear and struggle shift to trust and peace; denial melts into acceptance. At first, family problems and the need for reconciliation are urgent, but gradually these concerns fade. By delineating these processes, Renz helps practitioners grow more cognizant of the changing emotions and symptoms of the patients under their care, enabling them to respond with the utmost respect for their patients’ dignity.Less

Dying : A Transition

Monika Renz

Published in print: 2015-10-06

This book introduces a process-based, patient-centered approach to palliative care that substantiates an indication-oriented treatment and radical reconsideration of our transition to death. Drawing on decades of work with terminally ill cancer patients and a trove of research on near-death experiences, Monika Renz encourages practitioners to not only safeguard patients’ dignity as they die but also take stock of their verbal, nonverbal, and metaphorical cues as they progress, helping to personalize treatment and realize a more peaceful death. Renz divides dying into three parts: pre-transition, transition, and post-transition. As we die, all egoism and ego-centered perception fall away, bringing us to another state of consciousness, a different register of sensitivity, and an alternative dimension of spiritual connectedness. As patients pass through these stages, they offer nonverbal signals that indicate their gradual withdrawal from everyday consciousness. This transformation explains why emotional and spiritual issues become enhanced during the dying process. Relatives and practitioners are often deeply impressed and feel a sense of awe. Fear and struggle shift to trust and peace; denial melts into acceptance. At first, family problems and the need for reconciliation are urgent, but gradually these concerns fade. By delineating these processes, Renz helps practitioners grow more cognizant of the changing emotions and symptoms of the patients under their care, enabling them to respond with the utmost respect for their patients’ dignity.

In this chapter, the tertiary level of health promotion is the focus and the link between health and care is seen most clearly. It is argued that at this point in history, the association between old ...
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In this chapter, the tertiary level of health promotion is the focus and the link between health and care is seen most clearly. It is argued that at this point in history, the association between old age and death is at its strongest and that this has implications for how both ageing and death are perceived. In the context of long-term illness and at the end of life the need for care increases but socioeconomic inequalities are evident in older people's access. Both formal and informal (family) care provision and the relationship between these two are discussed in different contexts. The conceptualisation of care in policies is critically examined and it is argued that in long-term care the inadequacy of policy agendas is starkly apparent, as seen in the reduction of the human need for care to managerialist agendas.Less

Care for health in later life

Liz Lloyd

Published in print: 2012-05-16

In this chapter, the tertiary level of health promotion is the focus and the link between health and care is seen most clearly. It is argued that at this point in history, the association between old age and death is at its strongest and that this has implications for how both ageing and death are perceived. In the context of long-term illness and at the end of life the need for care increases but socioeconomic inequalities are evident in older people's access. Both formal and informal (family) care provision and the relationship between these two are discussed in different contexts. The conceptualisation of care in policies is critically examined and it is argued that in long-term care the inadequacy of policy agendas is starkly apparent, as seen in the reduction of the human need for care to managerialist agendas.

In the final chapter, areas of future research in gaining a better understanding the functions of the endocannabinoid system and the effects of cannabis on this system are envisioned. It is critical ...
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In the final chapter, areas of future research in gaining a better understanding the functions of the endocannabinoid system and the effects of cannabis on this system are envisioned. It is critical to investigate the effects produced by various strains of marijuana with different ratios of THC:CBD and other cannabinoids. As well, little is understood about the interaction between marijuana and other drugs, in particular alcohol. Cannabinoid designer drugs, for example Spice, are discussed. Some of the difficulties in conducting valid and reliable human clinical research with marijuana are discussed. A special case is made for palliative care. Finally, risks and benefits of marijuana use for both medicinal and recreational purposes are discussed.Less

Where Do We Go from Here?

Linda A. Parker

Published in print: 2017-03-01

In the final chapter, areas of future research in gaining a better understanding the functions of the endocannabinoid system and the effects of cannabis on this system are envisioned. It is critical to investigate the effects produced by various strains of marijuana with different ratios of THC:CBD and other cannabinoids. As well, little is understood about the interaction between marijuana and other drugs, in particular alcohol. Cannabinoid designer drugs, for example Spice, are discussed. Some of the difficulties in conducting valid and reliable human clinical research with marijuana are discussed. A special case is made for palliative care. Finally, risks and benefits of marijuana use for both medicinal and recreational purposes are discussed.